Q&A: Early Career Member Explains How He Published an SSC Recommendation

The Scientific and Standardization Committee (SSC) of the ISTH, through its subcommittees, publishes recommendations regarding practical matters of research standards, methods and nomenclature. The Society encourages early career professionals to get involved in proposing and writing these documents. However, early career professionals may not be aware of participation opportunities, and navigating the task of writing and getting these documents published is still unclear.

Early Career Task Force: What is your training background, clinical and research interests?Geoffrey Barnes: I am a clinical cardiologist and vascular medicine specialist, having completed training in internal medicine, cardiovascular medicine, and vascular medicine at the University of Michigan. My clinical and research interests center around the care of patients with thrombotic disorders (e.g. venous thromboembolism and atrial fibrillation) as well as the management of anticoagulation care.

ECTF: How have you been involved with the ISTH and for how long?GB: I have been involved with ISTH since attending the XXIV Congress in Amsterdam (2013). Following that meeting, I was asked to help lead the newly formed Young Professional Task Force (now the Early Career Task Force). I served as chair of that committee for two years, and continue to serve as a committee member (Dr. Mandy Lauw is currently the chairwoman). I have also been involved with leading the ISTH webinar series and by leading a Control of Anticoagulation SSC recommendation communication piece on the nomenclature for oral anticoagulants.

ECTF: Are you serving in any ISTH committee?GB: In addition to serving on the Early Career Task Force, I also serve on the Education Committee mostly helping with the monthly webinar series.

ECTF: Tell us briefly about your recent SSC recommendation that was published in JTH?GB: We published a recommendation on behalf of the Control of Anticoagulation SSC regarding nomenclature for oral anticoagulants. As the oral factor Xa and direct thrombin inhibitors were introduced into clinical practice, a number of different terms were used to describe this new class of agents: newer/novel/direct/target-specific oral anticoagulants. At the same time, a few safety reports were published indicating that the abbreviation NOAC could be misinterpreted as No AntiCoagulation. To that end, we surveyed a number of thrombosis and hemostasis leaders to ascertain their most preferred name and abbreviation for this class of medication. Based on that survey data, we determined that “direct oral anticoagulant (DOAC)” was the most preferred term when intending to refer to the entire class of medications. However, it is also important to make distinctions between the mechanisms (e.g. factor Xa inhibitor vs. direct thrombin inhibitor) when clinically appropriate.

ECTF: How did this project start? Where did the topic idea come from and whom did you reach out to when you were first starting the project?GB: The idea for the project came from my initial frustration in trying to search for published literature for these new medications. Since different terms were being used, it was hard to perform a single search. I then became aware of the safety concern with the abbreviation NOAC from my collaborator, Dr. Jack Ansell. During the 60th SSC Meeting in Milwaukee, I approached Dr. Walter Ageno (chair of the Control of Anticoagulation SSC) about this conundrum and he encouraged me to submit a proposal for a formal SSC recommendation.

ECTF: What steps did you have to take to move this project from an idea to a completed and published SSC recommendation?GB: I knew that it would be important to have strong mentors and collaborators on this project. So I reached out to both Dr. Ageno and Dr. Ansell. I also reached out to Dr. Scott Kaatz, whom I had worked with previously and who had lead similar Control of Anticoagulation SSC recommendation projects. Together, we developed the proposal and received approval from the SSC leadership team. Because we wanted this to be a consensus-style publication, we reached out to the leadership of 16 thrombosis and hemostasis organizations across North America and Europe to participate in the survey and to endorse the final recommendations. We received a significant amount of support from the ISTH office staff!

ECTF: How does this article differ from a regular research article published in JTH?GB: Unlike a more traditional research publication, an SSC recommendation is meant to provide specific recommendations on an important clinical or research topic. Each SSC recommendation is different and will require different skills. For my specific project, we had to develop and analyze a survey. We also attempted to gather endorsement from as many of the participating societies as possible. Finally, the format of the recommendation publication is very different than a traditional research publication. While we still had to provide clinical context and a description of our methods, we focused the manuscript primarily around the specific recommendations and our justification for those recommendations.

ECTF: Were there any specific skills or knowledge that you think are necessary to lead an SSC recommendation project that might be different from leading a more traditional research project?GB: The biggest hurdle for me was learning the process of submitting a proposal for an SSC recommendation and then getting endorsement from other societies. I had never done either of these activities previously. Also, tracking survey responses and providing timely reminders to our office.The invited survey respondents was important. Lacey Schmeidler, from the ISTH office, was an invaluable resource for this task and many other parts of the project. One of the key lessons I learned from this project was the true international nature of ISTH. When we proposed the project, we had identified many thrombosis and hemostasis organizations in North America and Europe to participate. However, not until after I presented the results at the XXIV Congress in Toronto did I realize (thanks to audience member feedback) that we had mistakenly neglected to include Asian, African, Australian and South American organizations.

ECTF: We noticed that your co-authors are from a variety of institutions and continents. How did you assemble that team to work with you on this SSC recommendation statement?GB: I had not previously worked with either Dr. Ansell or Dr. Ageno. However, both were eager to partner and mentor me on this project. I approached Dr. Ageno in person during the SSC meeting in Milwaukee. I approached Dr. Ansell via e-mail. I had previously worked with Dr. Kaatz on other research projects, so he was a logical partner and local mentor for me on this project.

ECTF: Some early career researchers may require help with editing and language, any advice?GB: I think that having a strong team of mentors and collaborators will make any project better. This includes helping with the writing and communication aspects of the project. If you feel that you are not a polished writer in English, ensuring that one of your collaborators on the project will help review the manuscript can be incredibly useful.

ECTF: How has this project benefited your career?GB: Most importantly, this project helped me connect with key leaders in the field whom I had not previously met (Ageno and Ansell). It also gave me an opportunity to present my work at the XXIV Congress in Toronto and a high-impact publication in JTH. Lastly, the skills that I learned developing the proposal, administering and analyzing the survey, and writing the recommendation manuscript will be incredibly valuable for future projects.

ECTF: Do you have any advice for other early career members of ISTH who might be interested in getting involved with or leading an SSC recommendation or ISTH guidance document?GB: My biggest piece of advice is to get involved! If you have a clinical or research question that you think could be addressed in an SSC recommendation or a guidance/guideline document, bring it up! The SSC and Guidance/Guideline leaders are always looking for new projects and new leaders, and they enjoy working with early career members. You never know, a question that you bring up to your SSC chair may someday turn into a published manuscript and oral presentation at an ISTH meeting!